Pulmonary Hypertension

New Preliminary Diagnosis

10/19/2010

Question:

I`m a 60 year old man who has been having serious dizzy and near fainting spells for about two years. These always happen after standing and walking for about 20 seconds or so and are getting worse. I had a serious bicycle accident recently, which likely was caused by a fainting episode, and caused us to try to find out (again) what is going on.

My heart checks out ok except that the echocardiogram showed a artery pressure of 50 (I assume that this is a mean number). My cardiologist says this may indicate moderate PH. My internist says she wants to run a sleep test next. It would seem to me that the next thing would be to confirm the PH question and do a Right-Heart Catheterization or a 6 minute test.

Any thoughts on next steps? Should I see a pulmonary specialist?

Answer:

The pressure measured by the echocardiogram is an estimate of the pulmonary artery systolic pressure.

The sure way to confirm or exclude pulmonary hypertension would be a right heart catheterization.

Sleep apnea can contribute to an increase in pulmonary artery pressures and a sleep study is indicated as part of the evaluation if it suspected clinically based on symptoms and examination.

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